No sooner have the news reports ended, are we commencing speculation over a ‘new’ drug. Earlier this year there was wide spread panic over the use of Meldonium which was recently banned. Now, a similar drug is coming to the forefront of sporting conversation; Actovegin.

Gaining prominent media attention back in 2000 when Lance Armstrong was supposedly caught attempting to bring a lot of it across the French border, Actovegin has since taken a back step and has been left as somewhat ambiguous and questionable in terms of its effects and use within the sporting environment, until more recently. New research is now showing just how well it can enhance sporting performance across many different sports.

Actovegin is a physiological amino acid mixture made up from the extract of calve’s blood, ultra filtered calf serum sourced from calves below 8 months old (Lee, Nokes & Smith, 2012) . This blood goes through many repetitions of ultrafiltration processing. This removes all the protein from the blood and leaves a concoction of unknown molecules including protein fragments, intermediaries of steroid hormones, amino acids and sugars to name a few. The way in which it works is that it enhances cellular metabolism and respiration. The drug enables glucose into the muscle cell faster and aids the burning of that fuel to happen more efficiently. It has previously been shown to improve the transportation and utilisation of oxygen and glucose, activate the aerobic routes of energy metabolism and improve the functional state of the central nervous system (Boiarinov, Penkovich & Mukhina, 1999). Actovegin has been shown to provide considerable acceleration of muscle fibre synthesis in damaged muscle aiding muscle recovery for athletes (Orchard et al., 2008).

However, a study examining the use of Actovegin on peak aerobic capacity using exhaustive arm crank ergometry tests on 8 particpants concluded that Actovegin did not influence functional capacity in the context used for this study (Lee, Nokes & Smith, 2012). Hardly surprising when you use just 8 participants.

In contrast, a recent study has shown that the efficiency of the mitochondria in the cell is enhanced in a concentration-dependent manner (Søndergård, Dela, Helge & Larsen, 2016). In this study, mitochondrial respiratory capacity in permeabilised human skeletal muscle was measured after being exposed to Actovegin in a low or high dose. This research showed that Actovegin has a marked effect on mitochondrial oxidative function in human skeletal muscle. In other words, the muscle cells are able to burn more oxygen faster after being exposed to Actovegin. This effect was shown to be more prominent with the higher dose of Actovegin.

Further research is needed to conclude the effects of Actovegin in elite athletes and how it would work for an individual who is already highly trained in terms of physiological capability. But the question as to how well it works in vivo is now out there, and if the people who are rumoured to have taken it for many years are anything to go by, it seems to work pretty well!

Although Actovegin is currently not on the World Anti-doping Agency’s (WADA) prohibited substance list, WADA does ban injections of any substance that exceeds the dose of 50ml every six hours – the amount similar to the dose shown to induce such performance enhancement effects in previous research. If the ingredients of it don’t make you question its use, the fact that Actovegin has to be injected to be used certainly should make you question just how ‘natural’ the drug is.

The use of Actovegin as a performance enhancer is definitely something that needs to be clarified within a wide range of sports. If it does have the performance enhancing effects that research leads us to believe then it may be following a similar path to Meldonium. As the doors open to a backlash of scrutiny over the use of many drugs within athletics, with Russian athletes being confirmed as banned from this years Olympic games in Rio, the question everyone should be asking is, just how many more substances are there out there having a similar effect as Meldonium and Actovegin that we are yet to discover?